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Home My WebLink AboutZ-31095FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31095 Date: 08/08/05 THIS CERTIFIES that the building Location of Property 23650 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 018 Subdivision DWELLING ORIENT (STREET) (HAMLET) Block 0005 Lot 016.001 Filed Map No. __ Lot No. __ confozms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 31095 dated AUGUST 8, 2005 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ACCESSORY WOOD FRAME GARAGE * The certificate is issued to HENRY WERNIKOWSKI (OWNER) of the aforesaid building. SUFFOLK COLSFI"fDEPARTMENT OF HRALTHAPPROVAL ELRc~-KICAL CERTIFICATE NO. 2065335 PLUMBERS CERTIFICATION D~r~u *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A S/~/05 N/A BUILDING DEPARTMENT TOWN OF SOUTEOLD HOUSING CODE INSPECTION REPORT ORIENT NAP ~O.: HENRY WERNIKOWSKI VIOL~TIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA5 This application must be filled in by typewriter or ink and submitted to the Building De[ A. For new building or new use: 1. JUL ? ?_O TO~, · , '~l r~ j Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sw~m statement fr~m p~~mber certifying that the s~~der nsed in system c~ntains ~ess than 2/ ~ ~ ~f ~ % ~ead. 5. Commemial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of preperty showing all preperty lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. July 27, 2005 New Construction: Location of Property: 2 3 6 5 0 House No. Owner or Owners of Property: Old or Pre-existing Building: X (check one) Main Road Orient Street Hamlet Henry Wernikowski Block 05.00 Lot 016.001 Filed Map. Lot: Applicant: Underwriters Approval: Suffolk County Tax Map No 1000, Section 018.0 0 Subdivision Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: X (check one) Fee Submitted: $ 1 0 0.0 0 " "~.'pp I ic ant Signature Henry Wernikowski NEW BY THIS CERTIFICATE OF COMPLIANCE THE YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STRE~-I ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by HENRY WERNIKOWSKI 1131 WOODCREST AVENUE RIVERHEAD, NY, 1190%2015 HENRY WERNIKOWSKI 23650 RT 25 ORIENT, NY 11957 Located at 23650 RT 25 ORIENT, NY 11957 Application Number: 2065335 Certificate Number: 2065335 Section: Block: Lot: Building Permit: BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, generator, Detached Garage, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 4th Day of August, 2005. Name QTY Rate RatinA Circuit Typc Miscellaneous cord and plug connected 4kw generator with transfer sw Alarm and Emergency Equipment Generator Portable Connection Transfer Switch Wiring and Devices Receptacle I 0 4kw ! 0 200 amp I 0 GFCI seal I of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~iSULATION [ ] FRAMING [ ~'/]/FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: